News Release
Telemedicine Can Help Safety-Net Providers Expand Specialized Medical Services
Jul 29, 2020
Download Free Electronic Document
| Format | File Size | Notes |
|---|---|---|
| PDF file | 0.2 MB | Use Adobe Acrobat Reader version 10 or higher for the best experience. |
Research Questions
- What types of practices were perceived to be promising?
- What goals were each practice supposed to accomplish?
- What was the context in which each practice seemed to be most suitable?
As part of the Sustainable Models of Telehealth in the Safety Net initiative process evaluation, staff from health centers in California described numerous promising practices that facilitated telemedicine implementation. In the context of the initiative, a promising practice was defined as a practice that shows potential to support the growth and sustainability of telemedicine programs in safety-net settings. Promising practices are associated with successful outcomes in certain circumstances. However, there is not yet sufficient evidence to prove that they will be effective across settings. The practices discussed in this report fall into the following categories: practices to reduce or manage no-shows, practices to facilitate communication between primary care providers and specialists, practices for negotiating favorable contracts with telemedicine providers, practices to reduce obligations for on-site staff, practices to improve patient buy-in for telemedicine, practices to improve provider buy-in for telemedicine, practices to improve sustainability, and miscellaneous practices.
Key Findings
Reducing no-show rates was a priority for many telemedicine coordinators
- All participating health centers described efforts to offer transportation support between patients' homes and the health center, attempted to schedule other patient encounters on the day of the telemedicine visit to increase efficiency and save patients multiple trips, and reminded patients about upcoming appointments and asked them to confirm their attendance.
Communication problems between providers resulted in poor coordination of services
- Some health centers assigned telemedicine coordinators or medical assistants to monitor the return of laboratory tests, notify primary care providers (PCPs) about results, and notify patients about next steps.
- Other health centers encouraged direct communication between PCPs and telemedicine providers by giving telemedicine providers access to the health center's electronic medical record system and ensuring that contracts with telemedicine vendors included language requiring opportunities for clarification about diagnoses, treatment plans, and follow-up questions.
Health centers found it difficult to negotiate contracts with telemedicine providers
- Although most health centers paid telemedicine providers for blocks of time regardless of the number of visits that occurred, three health centers negotiated contracts in which the telemedicine provider was paid for completed visits. This model was considered to be more sustainable for health centers because they were not penalized for no-shows and telemedicine providers had greater incentive to be productive.
Related Products
Research conducted by
This research was funded by the California Health Care Foundation and conducted by the Access and Delivery Program within RAND Health Care.
This report is part of the RAND Corporation research report series. RAND reports present research findings and objective analysis that address the challenges facing the public and private sectors. All RAND reports undergo rigorous peer review to ensure high standards for research quality and objectivity.
Permission is given to duplicate this electronic document for personal use only, as long as it is unaltered and complete. Copies may not be duplicated for commercial purposes. Unauthorized posting of RAND PDFs to a non-RAND Web site is prohibited. RAND PDFs are protected under copyright law. For information on reprint and linking permissions, please visit the RAND Permissions page.
The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.